


One in a Thousand

by SeaDog11



Category: The West Wing
Genre: Angst with a Happy Ending, congenital heart defect
Language: English
Status: Completed
Published: 2021-02-14
Updated: 2021-02-14
Packaged: 2021-03-15 15:08:46
Rating: Teen And Up Audiences
Warnings: Creator Chose Not To Use Archive Warnings
Chapters: 1
Words: 7,006
Publisher: archiveofourown.org
Story URL: https://archiveofourown.org/works/29438040
Author URL: https://archiveofourown.org/users/SeaDog11/pseuds/SeaDog11
Summary: Post series: Josh and Donna spend Valentine’s Day at the children's hospital with baby Noah.
Relationships: Josh Lyman/Donna Moss
Comments: 13
Kudos: 26





	One in a Thousand

**Author's Note:**

> This story is very near and dear to my heart.
> 
> Congenital Heart Defect Awareness Week: February 7th through February 14th. Post series: Josh and Donna spend Valentine’s Day at the children's hospital with baby Noah.
> 
> Trigger warnings: Congenital Heart Defect, angst with a happy ending

The light touch of the rain against our bedroom window wakes me up. I slowly open my eyes and see that I’ve beaten the alarm by a solid fifteen minutes. I turn it off and go back to how I was- snug against Donna, my hand resting on her stomach. She feels warm against my body, and her heat combined with the sound of water droplets against the glass could easily put me back to sleep. 

But not today. Today is the big day, the one we have been anxiously anticipating since August. Since our anatomy scan. That was the day our world shattered for a few hours. I remember it like it was yesterday. It’s just one of those moments that will be burned into my mind for the rest of my life. I don’t think someone can really ever get over the trauma of hearing that their unborn baby has a severe heart defect.

I remember I was holding Donna’s hand during the ultrasound. The tech said things here and there and was friendly, but she couldn’t really say much, they aren’t supposed to. Everything was perfect, we got the obligatory “It’s a boy!” sonogram photo, even though we already knew from genetic testing; we saw his profile, and all the stuff you expect at the “big” ultrasound. But then, then the last part of the ultrasound took place. 

Looking at Noah’s heart.

The tech got quiet, like she was really focusing. Donna and I didn’t think anything of it at first, we just figured she needed to concentrate. But then she left, and after what felt like forever, she came back along with the perinatologist. The room suddenly felt very cold. I knew something was wrong, I could feel it. So did Donna. I hardly remember hearing the doctor introduce herself.

She took the doppler and pressed it firmly against Donna. Seeing my wife in any form of discomfort is not okay. She moved the wand around Donna's abdomen, mumbling to herself. I was about to jump in and say something, but Donna squeezed my hand. The doctor clearly needed to look at something, so Donna was pushing through the discomfort. 

"Wow your baby is not cooperating." She rolled her eyes as she continued to push with the doppler. I wanted to rip into her, bring out the political animal in me. My baby has no control over what he's doing in there, and this asshole doctor is playing the blame game. Instead though, I just kept quiet. Yelling wouldn't solve anything, and we needed to hear what the doctor was about to say.

“I have some concerns about your baby’s heart, but everything else looks great," she said without a care in the world as she placed the doppler back in it's cradle and tossed Donna a towel to clean the sticky gel off her belly. I’m not sure why this particular doctor thought a rose and a thorn would be helpful here, but it sure as hell wasn’t. I’m a political operative, I know when someone’s beating around the bush.

“Okay . . .” I heard Donna’s voice trail off, her hand squeezing mine. I took the towel in my other hand and gently wiped the gel off, hoping that my soft circles on her bump would soothe her.

“Mr. and Mrs. Lyman, I’m pretty sure your baby has a severe heart defect. I don’t even want to tell you what it is, because I don’t want you to start researching it. Let’s get you to Children’s National for an echocardiogram.” She busied herself with finding a form and passed it to the tech, not seeming to care that she just gave us some of the most devastating news that soon to be parents can receive. And who the hell did she think she was, keeping medical information from us? I wasn’t going to let this fly. At some point, I would be looking into her background and credentials.

“What do you mean severe heart defect?” I kept my tone even, despite the anger I felt.

“Well, there’s definitely something wrong with your baby’s aorta.”

Before I even had a chance to reply, my strong, direct wife cut right to the chase. She asked the question that was on both our minds, what neither of us wanted to voice, but Donna found her courage, because that’s who she is. 

“Are we talking about termination here? You’re saying it’s severe. What does that mean? I’m not a doctor and neither is my husband.” I heard Donna’s voice choke on the last words as she struggled to finish her sentence, her hands protectively cradled her bump, keeping our unborn son safe the only way she knew how.

Oh, no. Not termination. The pediatric cardiologist can get a better look and figure out what’s going on.”

“They can get you in today,” the tech announced with a smile after she re-appeared in the room. “One o’clock.”

“Well that’s great news. Waiting over the weekend is never fun.” The doctor smiled before saying goodbye and leaving. The tech let us know that we could take our time, and wished us the best. She was trying to be nice, and I could tell this wasn’t easy for her. Donna immediately stood up and she was in my arms within a nanosecond. I just held her and rubbed her back as she cried. “Our baby is sick, Josh. Noah’s sick. There’s something wrong with our baby’s heart.” Her words were muffled between her sobs, but I heard them clear as day. Her chest heaved against mine and I refused to cry loudly. I let tears fall from my eyes, leaving a trail on my cheeks, but I needed to be strong for Donna. She needed me, I needed her, we needed each other. 

I remember it felt like forever for our cardio appointment that day. Neither of us felt like going back to work; we just needed to be together, we needed to process, and we needed to make a phone call. We spent a good hour and a half on the phone with Dr. Bartlet. She went over every possible congenital defect of the aorta that was known to man, she provided comfort when she knew we needed it, and President Bartlet kept us distracted in his unique way. They told us to eat and to call that evening with the results. “I’ll say a prayer for your son, Josh.” I remember the sincerity in President Bartlet’s voice as he said those words.

At the appointment, I could tell Donna was cold as Jean, the Echo Technician, rolled the doppler over Donna’s belly, getting what she needed. I could hear Noah’s heart so clearly and it sounded perfect, I just couldn’t fathom how something could be wrong. It didn’t make sense to me. I would do anything to make sure he was okay.

I covered Donna with my plaid overshirt, trying my best to keep her warm. She fell asleep as she gently rubbed soothing circles over our son. I couldn’t stop watching the movement. Somewhere in my mind, I thought that if I concentrated on her rhythmic small circles, that Noah would be okay.

Twenty minutes felt like an eternity, it felt longer than waiting for a meeting with a republican senator, but when Dr. Trang came in and introduced herself, the room felt suddenly warm. Somehow I knew that things were going to be okay. The weight we felt all day started to lessen. Donna even removed my shirt from her body as she sat up.

“Mr. and Mrs. Lyman, I’m Dr. Trang. I’ve taken a look at the echo results, and I’m not concerned.” The smile on her face was contagious, as I saw Donna slowly smile, and felt one appear on my own face. “Your baby has what’s called a Right-Sided Aortic Arch. It’s a congenital defect of the aorta, and it’s rare, about one percent of the population have it, and one in a thousand babies will be diagnosed with it every year.”

“One in a thousand?” My eyebrows shot to my hairline. I was absolutely shocked that our baby is a rare statistic. How the hell does that happen? 

“Yupp.” She smiled as she pulled out a pen and paper.

“Is it genetic?” Maybe I have it. Maybe Donna has it.

“Nope. Just one of those anomalies that happens in utero. Cardiac defects are the most common birth defect.” Okay so maybe Donna and I don’t have it.

“So our baby. He’s . . . he’s okay?” I heard the hope in Donna’s voice, it reflected what my eyes were showing.

“He is, Mrs. Lyman. I know this whole day must have been horrifying. I saw your chart, and I’m sorry that your son was misdiagnosed with a severe heart condition. He has a condition, but it’s not severe. Here let me draw you a picture and explain what I’m seeing . . .”

So in the end, we stood there alone in the exam room, holding each other. Noah was going to be okay, but we understood what Dr. Trang was saying. We needed to come back when Noah was four to seven weeks old for another echo. And if a vascular ring is present, he will need surgery. Unfortunately, you can’t see that in an echo on an unborn baby. We can’t prepare for it and I know that eats at Donna. We just have to wait and see.

The idea of Noah having surgery terrified us, and from time to time we would break down and talk about how scared we were at that possibility. Donna and I had had enough tragedy to last a lifetime, and it just wasn’t fair that our baby might need surgery. Hadn’t we paid our dues? Hadn’t we had our fair share? We couldn’t even find it in us to poke fun at Donna’s love of facts with the one in a thousand statistic. I found myself leaning on Sam and farming out more work to him. I needed to spend more time with Donna, and I wanted to be at home earlier in the evenings with her, especially late in her pregnancy.

We kept the diagnosis pretty quiet, choosing to share with Sam and Ainsley, Matt and Helen, Donna’s parents, my mom, and the Bartlet’s. Dr. Bartlet had said this was the best possible outcome, and she was happy with the results. On tough days, Donna and I would remember that. It became kind of a mantra for us.

Then came Noah’s birth, and it went beautifully. In the back of our minds we had been nervous about his heart and what to expect at birth, but thank God he was born perfectly healthy, 7 pounds 9 ounces. That was truly the moment I realized that eventually everything was going to be okay with his health, surgery or not. He was screaming at the top of his lungs, and the NICU team, who had been on standby, smiled and clapped, then politely left the room after happily announcing that they wouldn't be needed.

The humming of the radiator brings me back to the present. I squeeze Donna gently as I burrow into her hair and neck. She's absolutely intoxicating: morning, noon, and night.

"Mmmm good morning," she tells me in her sleep induced voice.

"Good morning. Happy Valentine's Day," I whisper against her ear, trailing gentle kisses down to her neck.

"So the heart doctor on Valentine's Day? That's a good omen, I think." She giggles as she stretches her willowy body and I get a good look at her soft skin as her flannel pajama top slightly rides up. I can't help but run my hands over her. I know she's a little self-conscious about her postpartum body, but I think she's never looked more beautiful.

"I think so too. I'm gonna check on Noah and then shower. I got all your pump stuff ready last night." I point to her nightstand and then slowly begin to unbutton her top. Donna arches into my touch as I slide my hand up and down her sternum. We haven't had sex since Noah was born, and at Donna's six week postpartum check up last Wednesday, her doctor said it would probably be fine now, since everything looked good, but with Donna having needed stitches, waiting a few more weeks might be the best option. Of course we're taking the doctor's recommendation of waiting. In the meantime, we've found other ways to be intimate. 

I help Donna get adjusted comfortably with pillows as she puts on her hands free pumping bra. That thing really is a God send. She takes a drink of water as I turn the TV on and pass her the remote. She smiles at me, and I can’t help but lean in and kiss her deeply before leaving our bedroom.

“Good morning Josh, happy Valentines Day,” Donna’s mom greets me cheerfully from the kitchen. She’s been here for the past three days and I think this is the most sleep Donna and I have had since we brought Noah home. Carmella moved the bassinet into the guest room and has been getting up with Noah in the night. We’ve offered to take him every night, but she insists. This is how she wants to help. It was also really important to Donna to have her mom here this week for Noah’s appointment. Carm has been a nurse for almost forty years and has been a great comfort to Donna and I during the stressful times. She promised to interpret all the medical jargon that the doctor throws at us today.

“Good morning Carm, happy Valentines Day,” I smile before walking over to the living room to say good morning to my son, who’s happily asleep in his swing. “Good morning Buddy. It’s a big day for you today, but you don’t need to be nervous, okay? Mommy, Daddy, and Nonna will be with you the whole time.” I gently pat his wispy, auburn curls before walking back to the kitchen.

“How’d he do last night? Not too much trouble? I don’t think I heard him.”

“Sounds like someone was in a deep sleep, because he made a little bit of noise around 2am, but a warm bottle put him back out. That was the only time we woke up. So I’d say it was a pretty good night. I’m making pancakes with eggs and bacon this morning. It’s going to be a long day at the hospital. Do you want some coffee?”

“No thanks. We’ll do a Starbucks run on our way. I promised Donna I wouldn’t drink more than 20 ounces of coffee a day, and I really want a venti blonde roast.”

“Ahh, so saving all your caffeine points?” 

“Absolutely. Thanks for watching Noah last night and thanks for breakfast. I’m gonna shower and Donna’s pumping, so we’ll be ready in about 20 minutes for breakfast if that works.”

“Oh Josh, how many times do I need to tell you . . . You don’t need to keep thanking me. I’m happy to help with Noah. He’s my nipotino afterall. Go shower. 20 minutes is perfect.” She playfully admonishes me with a spatula in hand.

“Grandson?” I raise my eyebrows in question as I pour some orange juice for Donna. 

“Si,” she points the spatula at me again and chuckles. “You’re picking up some Italian.”

“At this rate, I’ll be dead before I’m fluent.”

“Well, Noah can teach you. I need someone else to talk to in Italian. Donnatella and Marcello both gave up.”

I chuckle a bit at that as I walk back towards the bedroom. Between his Nonna and Bubbe, Noah could be trilingual by the time he’s five.

O0o0o0o0o0o0o0o0o0o0o

I help Carm with the breakfast dishes as Donna gets ready for the day. She already got Noah dressed, and I gotta say my kid looks pretty freaking adorable in his baby jeans, and red ‘little heartbreaker’ onesie. I wish we could spend the day here as a family, snuggling our son, but it is something to look forward to tonight. 

I walk into our bedroom and find Donna putting the finishing touches of her makeup on, not that I think she needs any. She swears she has bags the size of Texas under her eyes and that a little concealer hides them. She gives me a quiet smile as she puts the makeup away and reaches for her brush. I take that moment to open the drawer in my nightstand to grab her Valentine’s Day gift and quickly open the long rectangular box. I’m not very stealthy, but Donna was rummaging through her girly stuff to find some kind of spray for her hair. I surprise her as I come up from behind and fasten the delicate clasp of the sterling silver heart necklace. “Happy Valentines Day, Donnatella. I love you,” I whisper as I trail kisses down her neck. I feel her body lean back against mine, and I see that she’s closed her eyes for a moment as her fingers glide across the delicate engravement on the heart pendant. 

“It says ‘Noah’ with his birthdate,” I tell her as she tries to look down and read it. 

“I love it Josh. It’s perfect. Thank you.” She turns in my arms and I hold her close. 

“You’re gonna ruin your makeup,” I tease her as I wipe the tears that are cascading down her cheeks.

“Hormones,” she chuckles a little as she sniffles. I’m really glad she loves her necklace, but I feel bad for making her cry. Hopefully this is the only teary-eyed moment today. Hopefully we get good news from the pediatric cardiologist.

“I have something for you too,” she smiles coyly as she walks over to her nightstand. I guess we both have a knack for choosing the same hiding spot for gifts. She comes back holding a white box with a red ribbon and hands it to me. I quickly become verklempt when I find myself staring at my favorite photo of us as a family set in an 8x11 sterling silver frame, “The Lyman Family December 2008” engraved in calligraphy. Mom took this photo. She’s been enjoying photography lately, and snapped this on New Years Eve. It’s a black and white photo of Donna and I smiling at Noah; his little fingers are wrapped around one of mine. 

“I know how much you love that photo. And you always look at it when you come home after a stressful day at work, so I thought this would be nice for your desk.” She smiles at me, the smile that is for me alone, and I come undone. “Come here, Donna.” I hold her against me as I hold back my own tears, but one or two escape. I can’t help it when I find her lips with my own and kiss her fiercely. 

“So I guess that means you like it?” She laughs a few minutes later, after our passionate embrace simmers.

“Like it!? I love it. It’s perfect. I can’t wait to put it on my desk. Thank you.” I give her another kiss for good measure.

“You’re welcome. Happy Valentine’s Day Josh, I love you.” She mirrors my words from earlier and my heart soars. I will never get tired of hearing her tell me that she loves me.

O0o0o0o0o0o0o0o0o0o0o

“So, are we ready? Is our Chief of Staff ready?” I ask the ladies as I point at a drooling Noah. Good thing we put a bib on him. It’s no joke, he really is the Chief of Staff around here.

“All set, the diaper bag is packed. I packed his bottle for the echo, and I will breastfeed him after that when he gets hungry again, there’s an extra outfit in there, a few diapers, wipes, cream, an extra blanket and binky, and our stuff. Anything else you think I need, mom? Josh?” I know Donna is prepared and organized, but I know she gets anxious about forgetting something for Noah. 

“All good,” Carm smiles as she grabs the diaper bag and swings it over her shoulder. I absolutely love that Donna purchased a backpack style diaper bag. It isn’t lost on me that she did that because she knows I prefer a backpack over any other bag. It’s worked out really well too, great storage and insulation for bottles. Donna likes it because it was locally made by a small family business.

“Sounds like we have it all. What do you say little man, you ready to go see the heart doctor?” I smile at Noah as I reach over to pick up his car seat carrier and I’m rewarded with a gummy smile. It’s better than any political victory. Smiling is one of the first milestones he hit, and I’m glad Donna and I got to see it together for the first time when we were changing him a few nights ago. I wish I had more time at home with Noah, but it really isn’t possible. Donna has been really great about bringing him to the White House pretty frequently since she’s still on maternity leave. It’s definitely Margaret’s favorite part of the week. Even if I can’t be home with him as much as I want to, I remind myself that the work we’re doing is going to make his life better. 

O0o0o0o0o0o0o0o0o0o0o

Our town car arrives at Children’s National about 30 minutes later. I’m feeling wide awake with the coffee cascading through my system, but Noah’s back asleep. He does really well with car rides; I had no idea that newborns sleep this much, but growing big and strong is a tough job when you’re barely 10 pounds. I’m glad Donna took a little nap too. I want her to get her sleep whenever she can.

We walk into the building with our agents: Patrick and Charmaine. We had a long meeting with Ron about today’s protocol, and I was adamant that the agents accompanying us wear casual clothes. Donna and I expressed our concern about parents being stressed out at the sight of agents in the children’s hospital. They already have enough anxiety. We were also told by Ron that he could have the pediatric cardiology schedule cleared for the afternoon, but we also declined that option. These families already have to wait long enough for an appointment as is, and we’re not adding to that wait time just so that it is easier for the Secret Service. It’s a visit to the children’s hospital, not a public event. Another option was for me to not go to the appointment, but no way in hell was that happening. Luckily Ron understood and made a plan that worked for us. I still can’t believe that Donna and Noah don’t have agents with them, just me. I want that changed. I want to know that my family is protected at home when I’m at the office.

“Oh cute they have Radio Flyer wagons for the kids,” Donna smiles and squeezes my hand as she continues to look around. The inside is bright and cheerful, as cheerful as you can get for a hospital. I don’t think either of us paid too much attention when we came here for Noah’s echo back in August. We both felt like we were in a fog that day. As I look around, I notice that there are several model hot air balloons filling the atrium and the walls are filled with Valentine’s Day decorations. The staff does a great job making it not feel like a hospital when you walk in. It kind of feels more like a resort lobby.

I smile back at Donna and look at the Radio Flyers. Noah’s car seat carrier will fit perfectly between the high wooden sides of the wagon, nice and safe. I pull one out and gently place Noah’s car seat carrier in it. I take the diaper bag from Carm and settle it in behind Noah.

“Oh, we need a picture of this! I’ll make sure I get doubles printed. Baby boy’s first wagon ride,” Carm says cheerfully as she digs through her bag for her camera. She finds it quickly and snaps a few photos of Noah in the wagon. It will be a great addition to his first year scrapbook that Donna is working on.

Carm puts her camera back in her bag and then we slowly wheel Noah over to the elevators. We already know that we are going to the fourth floor for the echo. We check in quickly and take our seats in the waiting area. There are so many families here, and I can’t help but pray to God in that moment that we won’t have to be one of those families that has to keep coming back here.

“Noah,” I hear a friendly voice from the doorway. We stand up and pull Noah’s wagon towards her and we are greeted with a warm smile. That’s something I’ve noticed, everyone here is kind and smiles. It really takes a special kind of person to work in a children's hospital. I can’t imagine what they go through on a daily basis. And I thought my job was stressful? My eyes have really opened up with this whole journey we have been on with Noah. 

“You’ll be in room seven for this little guy’s echo. He’s adorable by the way. The tech will be in shortly.” 

“Thank you Brandie,” Donna smiles as she begins to take Noah out of his carseat. I get his bottle and baby bear blanket from the diaper bag and together we get him down to his diaper before I scoop him up and hold him against my chest in his blanket. Donna takes his little red hat off and attempts to tame his curls. That will be a lifelong project, because he’s definitely got my hair.

A knock at the door pulls me from my thoughts, and I immediately recognize Jean, the echo tech from last time.

“Alright so what are we looking for today?” Jean asks as she smiles at us and takes her seat.

“A vascular ring for our son’s right aortic arch,” Donna says swiftly as we get Noah comfortable on the bed.

“Okay got it, so you’ve had an echo done already if you know he has a right sided arch. Probably in utero.”

“Yes, in utero, back in August,” Donna explains as she gives Noah a little bit of the bottle.

“Oh that’s right, I remember you folks now. I think we were even in this room,” Jean smiles and I’m glad that she remembers us. It makes it a little more personal, and I’m pretty impressed because it’s been six months and she’s probably seen a lot of patients since then. She would be great in politics with a memory like that. She actually reminds me of Debbie Fiderer a little bit.

“Well, let’s hope that we get good images today and that there isn’t a vascular ring, right little man?” She smiles at Noah as she starts to put the electrodes on his chest. “So we just gotta keep him still, a bottle is a great distraction. Babies get so wiggily, that’s why we try to have echos done as soon as possible,” Jean explains as she puts some warm gel on Noah and places the doppler on him. His heart pops up on the screen instantly and I can’t peel my eyes from it. I have no idea what I’m looking for, but I’m captivated by the rhythmic beat of his heart on the screen. 

Carm quietly points out a few things to me on the screen while Donna holds Noah close, feeding him his bottle. Every so often, Jean adjusts her settings and we get to hear Noah’s heartbeat. It’s been awhile since we’ve had that privilege, and my reaction is still complete ‘awwww’ over the sound. It hits me completely different now though, because I can see him, he’s right here with us.

“Okay that’s it, I got everything,” Jean announces as she gently wipes Noah’s tummy and removes the electrodes. “So we will send the results upstairs to pediatric cardiology, and Dr. Trang’s partner, Dr. Shaw, will be reviewing them and meeting with you today. It was great seeing you again, and congratulations on your little guy. Oh and take your time in here with getting him ready,” Jean smiles as we say goodbye and she leaves the room. Between the three of us, we have Noah dressed in no time and ready to wheel his wagon up to the seventh floor.

O0o0o0o0o0o0o0o0o0o0o

We’ve been waiting for about an hour and a half. No one was particularly hungry yet, so we settled into our little corner of the waiting room, enjoying the views outside that the large windows had to offer. Noah dozed off for a while, but now he’s content just being in his mother’s arms and snuggling against her. 

I’m looking at the ocean theme on the walls when Noah’s name is called. I take a deep breath, this is it, this is the moment we have been waiting for. I let Donna and Carm go first as I follow behind with Noah’s wagon. The exam room is small, but we all fit. Patrick and Charmaine wait right outside the door as they did during the echo, giving us our privacy. Donna smiles at Noah as she removes his outfit. The nurse quickly gets his height and weight, looks like he’s hit 10 pounds today. Before I know it, he’ll be too big for his carrier, and I’m reminded that time is flying by. I just want it to slow down, but unfortunately it won’t. I’m determined to take in every moment of Noah’s babyhood. Hell in five weeks he won’t be a newborn anymore. He’s already changing every day. I really hope his eyes stay blue. I’m reminded of Donna everytime I look into his eyes. 

“Dr. Shaw will be in shortly, are you folks okay with two medical students shadowing your appointment?” Allison, the medical assistant, asks politely. Donna and I look at one another and silently agree. We don’t want to take away anyone’s opportunity to learn.

“That’s fine with us Allison,” Donna states as she gently rocks Noah.

“Great, I will let her know. It was wonderful meeting you folks, have a nice afternoon,” Allison says before gently closing the exam room door. Barely five minutes later, the door opens and we are greeted by Dr. Shaw. Her friendly demeanor immediately puts me at ease. 

“So this must be Noah,” she smiles as Donna gently puts Noah on the exam table. Dr. Shaw coos at Noah and he smiles back, I can’t help but be proud of his cute little personality. 

“I have Jason and Shelby here with me today. They’re working on their pediatric rotation. Let’s pull up Noah’s chart,” she announces as Jason and Shelby walk over to the computer. 

“So Noah here has a right-sided aortic arch,” Dr. Shaw continues to address the medical students. 

“I saw that when I read his file a little while ago,” Shelby adds as she finds Noah’s chart in the computer system. Jason has a look of regret on his face as he realizes his classmate has done her research. You can see the underlying friendly competition. 

“Okay I want to get a listen here. I’m sorry buddy, this might be cold.” Dr. Shaw puts her stethoscope on and listens to Noah’s heart. The room goes silent for a moment. It makes me nervous, and I am not quite sure why. Maybe I’m nervous that she will find something wrong. The tension is relieved when Noah lets out a little gas and smiles, everyone laughs a little at that.

“Okay, everything sounds good. He has a soft murmur, here take a listen.” My heart pounds immediately at the revelation. I don’t want to interrupt, so I wait as Shelby copies exactly what Dr. Shaw had done. She let’s Noah grab her pointer finger while she places the stethoscope chest piece on him with her other hand. She listens for a moment and nods at Dr. Shaw. Noah again lets out a little gas and smiles, causing another round of soft laughter. Jason goes next and doesn’t offer Noah his finger. It irks me to some degree, because I could tell Noah had been enjoying grabbing fingers, and this kid either doesn’t care enough or wasn’t paying attention to see that this is what Dr. Shaw and his classmate were doing. I’ll cut him some slack though. He’s doing his rotations and he probably doesn’t want to go into pediatrics. Shelby ,on the other hand, might really be interested in this speciality. 

“I hear it,” Jason removes the stethoscope and Dr. Shaw takes over.

“A soft murmur? Is that bad?” Donna asks, with concern evident in her voice. I reach for her hand and squeeze lightly. 

“Oh no not at all. It’s common in infants, and Noah’s will go away.” Donna and I smile at one another, relief evident in our eyes.

“Alright let's look at the echo,” Dr. Shaw announces as she turns the computer towards us before continuing. “So based on what I see here, I suspect that Noah has a vascular ring growing, but I can’t confirm it. With these echos, a lot of times the ring is starting to grow at this age or it just isn’t clear enough to make a solid diagnosis. I know that doesn’t give you an answer today, but I can tell you that everything else I am seeing looks great. So with Noah, we’re going to need to do another echo when he’s about three years old. He’ll be able to sit still and if a vascular ring is present, we will definitely be able to see it.”

Donna and I look at one another. It isn’t exactly what we wanted to hear, but it is what it is. I feel like we need to press pause on this issue for a while, and that gives me anxiety beyond belief.

“Okay, so it sounds like we won’t have a definite answer for a few years, what are our next steps? What should we be looking for?” Donna asks calmly, but I can see the anxiety in my wife’s eyes.

“Great question,” Dr. Shaw starts. “ So a vascular ring is formed when the branches of the aorta, or the aorta itself, create a ring around the esophagus and/or trachea. The abnormal branch travels behind the esophagus and the vessel goes to the left subclavian artery.” Dr. Trang went over all of this months ago with us, and Dr. Bartlet has explained it as well, but it’s still pretty confusing if you’re a non medical professional. What sticks in our mind is that the big candy cane artery in Noah’s heart goes in the opposite direction, and he might have a ring of vessels that make it difficult for him to eat, breathe, and/or swallow. That’s how we will explain it to him when he’s older.

“So here is what you should be looking for,” Dr. Shaw continues. “Noisy breathing, especially when you start feeding Noah solids, trouble breathing in general, trouble swallowing when he eats solids, and a persistent cough. Do you hear stridor when he cries?” Donna and I look at eachother. We have no idea what stridor is.

“Mom? Have you heard that. You would know.” Donna looks to Carm for the answer.

“No, no strider. Just a typical baby cry.” Carm smiles as she addresses the doctor.

“That’s good. So let’s do this. If you see any of the signs I mentioned, call us immediately and we will reevaluate. If he doesn’t, just live your lives and come back in a few years.”

“So he’s okay? He’s not going to one day be running around and all of a sudden collapse?” Donna questions as she takes Noah from Dr. Shaw.

“Nope, not going to happen. It’s not that kind of heart defect. He’s going to live a healthy life, with maybe a surgery in there if there is a confirmed vascular ring.”

“Okay, well that’s good,” I add. “So basically, we make an appointment when he is three, and if the echo shows a vascular ring, he’ll need surgery. Until then, watch for any abnormal symptoms that could be signs that he’s struggling.” I want to make sure I get clarification.

“Yes exactly Mr. Lyman. And don’t hesitate to call if you have any questions.”

“And the surgery,” Donna stutters ever so slightly. “It isn't an open heart operation, correct? That’s what I read. You go through the ribs?”

“Yes. We would make an incision on the left side of his chest and remove the ring. On rare occasions we need to go through the middle of the chest, but again, that’s unlikely.” Dr. Shaw finishes her explanation, and I realize that my own hand is now resting on my chest scar. The fact that there is a chance that Noah will have a similar scar bisecting his chest causes a very raw pain inside me. I push it from my mind, reminding myself of the unlikeliness of that outcome.

“Thank you, Dr. I think that’s all of our questions. Donna? Carm?” I look to my left for confirmation.

“Yeah I think that’s everything.” Donna smiles as she thanks the doctor. It is an absolute relief that we are walking out of here today without having to plan on a surgery for Noah in the near future. I can see that she feels more calm. The fear we have been carrying around for months has lessened drastically. 

“Okay, well again don’t hesitate to call, it was a pleasure meeting with you today. Take all the time you need to get ready, if you need to nurse, the room is yours.” And with that, Dr. Shaw and the medical students leave. 

“So, for now, no surgery.”

“No surgery,” Donna smiles.

“You hear that, little man, we don’t have to come back here for a while.” Donna and I both snuggle Noah for a moment. We didn’t get a clear answer, but for the immediate future, we are in the clear, and that’s definitely something to celebrate. Perspective is everything.

O0o0o0o0o0o0o0o0o0o0o

“Long day,” I yawn as I crawl into bed and wrap my arm around Donna, our eyes both glued to Noah’s bassinet. We convinced Carm to let us take Noah for the night, we just needed to be close to him. I needed my little family all together.

“It was,” Donna mimics my yawn with her own. She turns and smiles at me, giving me a quick kiss before turning back to look at Noah’s sleeping form. “I loved my Valentine’s Day gifts, those roses are beautiful, and my mom loves her bouquet. Noah has good taste. I’m still not sure how they got into our apartment while we were gone today.”

“We have our ways, and he wanted to make a big impression on his first Valentine’s Day.”

“Did he pick out the chocolate turtles too?”

“He may have had a little help from me.”

“Of course. He had to ask his deputy’s opinion, these are important matters. They were delicious, by the way.”

“I’ll tell him when he wakes up tomorrow.” 

“You know, when we have another baby, that little one will be Deputy Chief of Staff, and you’ll be Deputy Deputy Chief of Staff.” I feel Donna’s laugh as much as I hear it as her body vibrates against mine. I can’t help but smirk.

“Well I seem to remember having my very own Deputy Deputy Chief of Staff for many years, and I found her to be  _ very  _ valuable.” I whisper the words as I kiss along her ear.

“Mmm, and whatever happened to your Deputy Deputy Chief of Staff?” Donna arches against me as I continue my ministrations.

“Well, she stopped being my ‘Deputy Deputy’, and became a powerful, political operative, then she married me, and then she had our baby.

“You bet your ass she did all that.”

“Mmmhmm, and more.” I plant a kiss on her lips as she turns in my arms. The mood suddenly changes from playful as Donna looks me in the eyes.

“How do you feel about today?” 

“You know, I feel pretty good. How are you feeling?” I ask as I rub my hand along her arm.

“At first, I went in really wanting a definitive answer, you know? And when Dr. Shaw explained that she couldn’t confirm if Noah had a vascular ring or not, I panicked for a brief moment, until I realized that it’s okay not to know. I can’t imagine what it would have been like, finding out that he has a vascular ring, and then having to have surgery as an infant. I like the plan that she laid out for us today. I feel really good about it.”

“Me too baby, me too. I think this is a good reminder for us to just breathe and take things one step at a time with his heart. Surgery or not, he’s going to live a healthy life, and right now, we don’t need to worry about a possible surgery in three years. Our next step is seeing how he does with solid food and making sure his breathing doesn’t become an issue.” 

“I like that plan,” Donna whispers as she kisses me goodnight and rolls back to face Noah. “Good night Joshua, I love you, happy Valentine’s Day.”

“Happy Valentine’s Day Donnatella, I love you, I love you and Noah more than anything. Good night.”

“And good night buddy, happy first Valentine’s Day, we love you,” we tell Noah together.

“You’re our one in a thousand,” I whisper as I close my eyes.

  
  
  
  
  
  


**Author's Note:**

> For you, my little one. Happy 2nd Valentine’s Day :)


End file.
